Post by Nicole on Feb 20, 2007 18:34:46 GMT -5
You are just not going to believe what has been going on since I last wrote about Sunny’s neck situation. The past six weeks have been unbelievably hellish.
First, here is a brief recap of where we left off last time. Six months ago Sunny had an orange size mass in his neck. They surgically biopsied it and cultured it. They thought it was cancer. It wasn’t cancer. It was an abscess. No one knew how bacteria got in the neck without a penetrating injury. They drained it and it resolved. The cause was never discovered.
It then came back. They thought it was a hypersensitivity to the absorbable suture from when they did the first biopsy. A second biopsy at this time suggested an abscess but the culture said no bacteria.
That was where we left off.
Around Christmas time, the mass in the neck started growing again rapidly. Another biopsy was taken and suggested an abscess. The culture found an anaerobic bacteria (survives without oxygen).
Where was the bacteria coming from? Bacteria just doesn’t enter the neck tissue unless there is an opening to allow it in. There was no opening. No one knew why this was happening over and over again.
We decided to surgically remove the abscess (it was huge again) and perform exploratory surgery. This time they took x-rays and they had a new sophisticated sonogram machine. I had asked them to take an x-ray six months ago but they didn’t because they were so sure it was cancer.
Well the x-ray showed two pieces of a needle in his neck!!! They called me and I rushed in so we could discuss what they should do while Sunny was still under anesthesia. One piece is sitting on the cervical spine in the back of the head and would need a neurosurgeon to remove it. The other piece was in the soft tissue near the thyroid. We decided to try to get the soft tissue one out since this was closest to the abscess and likely causing it. After five hours of surgery, they could not find it. They said it was like trying to find a needle in a haystack.
One week later, they tried again. This time they used surgical clips as markers with many x-rays and they found the one piece of needle in the muscle near the thyroid with six inches of thread with it. It was a sewing needle. The last time I sewed was two years ago. I don’t sew. If something rips, I am lazy I use a safety pin. But I sewed a button on my coat two years ago. Sunny must have picked up the string and before he realized there was a needle on the end he swallowed it. Before swallowing it, he must have bit it. The tip of the needle broke off and passed through. The eye part broke off from the body. The thread broke from the eye piece and then wrapped around the piece that was the body of the needle.
The eye piece part migrated through the back of the esophagus to the cervical spine. The body and thread migrated out of the esophagus to the side and implanted in a muscle near the thyroid.
It was the thread that was harboring the bacteria like a retained suture. There was a microscopic fistula tract from the thread to the front of the neck where the abscess developed. So the cause of the abscess was not actually near the abscess. The body was attempting to expel the foreign object toward the exterior of the body and created the fistula tract. Amazing.
Sunny had a hole in his neck all the way in to the esophagus with an opening from under his snoot down to his chest. I won’t show you a picture of the incision this time because it is really very gross looking. A drain was placed, we had daily visits to the vet for weeks on end for flushing, morphine and opiates for the pain, then he ripped the sutures and had to be stapled, his bowels shut down for a few days from the five hours of surgery but came back, then he shook his head and the whole drain fell out and he was on mega antibiotics, he became mildly hypothyroid because the thyroid was irritated and in the end the expense for the past six months cost us close to $7,000. I demanded that they reduce the bill because they did not take the x-ray six months ago and they should have used markers during the first surgery and they agreed with me.
I am now very happy to report that the wound is healed beautifully, staples are out, antibiotics are finished and Sunny is doing fabulous. Animals heal amazingly fast. One day his neck was open and then it was closed.
About two years ago at or about the time I sewed the button, Sunny went into an itching frenzy for months on end and a cause could not be found. I posted about that two years ago. Some of you may remember. I will bet that his immune system went crazy to mount a defense around the needle at that time and caused the systemic allergic reaction. The vets just dismissed me at the time as overreacting because I wanted to know why this was happening and no one could tell me. They just said allergy.
The eye part of needle is still there and we will return in 4 weeks for an x-ray to see if it stayed put and then a blood test in three months to make sure the thyroid is back to normal. The needle was not causing the infection, the thread was and that is now out. So if the eye part stays put, I am leaving it alone because it is on the spine and he can die or be paralyzed if they try to remove it. I have consulted with a neurosurgeon who is on stand by should we need to remove that one. People live with bullets and shrapnel in them. The difference is that a needle is sharp and doesn’t have much resistance so we do not want it to migrate anywhere. But I don’t know if I would put Sunny through any more surgery. It was so painful for him and just hell for him.
I am just so happy that this is finally resolved. I hope it is resolved anyway.
The moral: There is always a cause for a symptom. Don’t let anyone dismiss symptoms without determining a cause. A dog speaks to us with a change in behavior. Always pay attention. I have said this before…if something is different, something is wrong.
So I have been a little busy for the past two months!! ;D ;D
First, here is a brief recap of where we left off last time. Six months ago Sunny had an orange size mass in his neck. They surgically biopsied it and cultured it. They thought it was cancer. It wasn’t cancer. It was an abscess. No one knew how bacteria got in the neck without a penetrating injury. They drained it and it resolved. The cause was never discovered.
It then came back. They thought it was a hypersensitivity to the absorbable suture from when they did the first biopsy. A second biopsy at this time suggested an abscess but the culture said no bacteria.
That was where we left off.
Around Christmas time, the mass in the neck started growing again rapidly. Another biopsy was taken and suggested an abscess. The culture found an anaerobic bacteria (survives without oxygen).
Where was the bacteria coming from? Bacteria just doesn’t enter the neck tissue unless there is an opening to allow it in. There was no opening. No one knew why this was happening over and over again.
We decided to surgically remove the abscess (it was huge again) and perform exploratory surgery. This time they took x-rays and they had a new sophisticated sonogram machine. I had asked them to take an x-ray six months ago but they didn’t because they were so sure it was cancer.
Well the x-ray showed two pieces of a needle in his neck!!! They called me and I rushed in so we could discuss what they should do while Sunny was still under anesthesia. One piece is sitting on the cervical spine in the back of the head and would need a neurosurgeon to remove it. The other piece was in the soft tissue near the thyroid. We decided to try to get the soft tissue one out since this was closest to the abscess and likely causing it. After five hours of surgery, they could not find it. They said it was like trying to find a needle in a haystack.
One week later, they tried again. This time they used surgical clips as markers with many x-rays and they found the one piece of needle in the muscle near the thyroid with six inches of thread with it. It was a sewing needle. The last time I sewed was two years ago. I don’t sew. If something rips, I am lazy I use a safety pin. But I sewed a button on my coat two years ago. Sunny must have picked up the string and before he realized there was a needle on the end he swallowed it. Before swallowing it, he must have bit it. The tip of the needle broke off and passed through. The eye part broke off from the body. The thread broke from the eye piece and then wrapped around the piece that was the body of the needle.
The eye piece part migrated through the back of the esophagus to the cervical spine. The body and thread migrated out of the esophagus to the side and implanted in a muscle near the thyroid.
It was the thread that was harboring the bacteria like a retained suture. There was a microscopic fistula tract from the thread to the front of the neck where the abscess developed. So the cause of the abscess was not actually near the abscess. The body was attempting to expel the foreign object toward the exterior of the body and created the fistula tract. Amazing.
Sunny had a hole in his neck all the way in to the esophagus with an opening from under his snoot down to his chest. I won’t show you a picture of the incision this time because it is really very gross looking. A drain was placed, we had daily visits to the vet for weeks on end for flushing, morphine and opiates for the pain, then he ripped the sutures and had to be stapled, his bowels shut down for a few days from the five hours of surgery but came back, then he shook his head and the whole drain fell out and he was on mega antibiotics, he became mildly hypothyroid because the thyroid was irritated and in the end the expense for the past six months cost us close to $7,000. I demanded that they reduce the bill because they did not take the x-ray six months ago and they should have used markers during the first surgery and they agreed with me.
I am now very happy to report that the wound is healed beautifully, staples are out, antibiotics are finished and Sunny is doing fabulous. Animals heal amazingly fast. One day his neck was open and then it was closed.
About two years ago at or about the time I sewed the button, Sunny went into an itching frenzy for months on end and a cause could not be found. I posted about that two years ago. Some of you may remember. I will bet that his immune system went crazy to mount a defense around the needle at that time and caused the systemic allergic reaction. The vets just dismissed me at the time as overreacting because I wanted to know why this was happening and no one could tell me. They just said allergy.
The eye part of needle is still there and we will return in 4 weeks for an x-ray to see if it stayed put and then a blood test in three months to make sure the thyroid is back to normal. The needle was not causing the infection, the thread was and that is now out. So if the eye part stays put, I am leaving it alone because it is on the spine and he can die or be paralyzed if they try to remove it. I have consulted with a neurosurgeon who is on stand by should we need to remove that one. People live with bullets and shrapnel in them. The difference is that a needle is sharp and doesn’t have much resistance so we do not want it to migrate anywhere. But I don’t know if I would put Sunny through any more surgery. It was so painful for him and just hell for him.
I am just so happy that this is finally resolved. I hope it is resolved anyway.
The moral: There is always a cause for a symptom. Don’t let anyone dismiss symptoms without determining a cause. A dog speaks to us with a change in behavior. Always pay attention. I have said this before…if something is different, something is wrong.
So I have been a little busy for the past two months!! ;D ;D